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Results for “Community Financing”

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At least 271 records · Page 15Linked to original sources
PubMed1979

Consumer participation and community organization practice: implications of national health legislation.

This paper reviews ten federal health laws from the perspective of the extent to which consumer participation had been incorporated as an integral aspect of health program, identifies some issues and dilemmas of implementing consumer participation activities, and offers suggestions for the involvement of consumer advocates. The review of the laws showed uncertainty of outcomes, conflicting philosophies, conflicting purposes, conflicting strategies, and conflicts relating to representativeness, legitimacy and consumer role. Despite the inconsistent record of Congress to legislate consumer participation, two recent health laws, P.L. 93-641 and Title III of P.L. 94-63, appear to offer major opportunities in promoting consumer involvement in planning and policy development activities. However, because these laws continue to delegate the responsibility for implementing consumer involvement programs to providers, established institutions and state agencies, consumer advocates are urged to increase their knowledge of the laws and to assist consumers to realize their right of self-determination. The cause is worthy and represents a desirable goal for public health--and in the final analysis, for the survival of our democratic society.

Community Mental Health Centers↗
PubMed1995

Payer and provider relationships: the key to reshaping health care delivery.

Though managed care is customarily thought of as the key point of connectivity for payers and providers, reshaping health care delivery requires a strong, united relationship between the two. The return to a health-related mission is a requirement of the new delivery system, which depends on moving beyond disease-based care and medical financing. In the future, community health status will be a strong indicator of success among payers and providers. Community-centered models of care for the underserved are illustrative of the opportunities for relationship building and strategic alignment between payers and providers.

Health Care Reform↗
PubMed2003

New directions for health insurance design: implications for public health policy and practice.

National attention on issues of public health preparedness necessarily brings into sharp focus the question of how to assure adequate, community-wide health care financing for preventive, acute care, and long-term medical care responses to public health threats. In the U.S., public and private health insurance represents the principal means by which medical care is financed. Beyond the threshold challenge of the many persons without any, or a stable form of, coverage lie challenges related to the structure and characteristics of health insurance itself, particularly the commercial industry and its newly emerging market of consumer-driven health plans. States vary significantly in how they approach the regulation of insurance and in their willingness to support various types of insurance markets. This variation is attributable to the size and robustness of the insurance market, the political environment, and regulatory tradition and custom. Reconciling health insurance markets with public health-related health care financing needs arising from public health threats should be viewed as a major dimension of national health reform.

Disaster Planning↗
PubMed1994

Implementing the Boston Healthy Start Initiative: a case study of community empowerment and public health.

This article examines the efforts on the part of a city health department, in partnership with a broad-based coalition of community-based, government, and social service agencies, to plan and implement, using principles of empowerment and community participation, a federally funded infant mortality reduction program. It examines the social and institutional dynamics of sharing power in an environment highly charged politically. Infant mortality in Boston is much more than a public health problem. It is the focal point of complex racial, political, and institutional factors. This case study illustrates how empowerment moves from rhetoric to reality and the challenge to both traditional public health practice and traditional community mobilization. The article describes the federal Healthy Start Initiative and its community participation mandate, the background on infant mortality in Boston, a case study of the development of the Healthy Start program from the perspective of community empowerment, and finally, the lessons learned in the first 2 years of the program. It describes the controversies encountered, some of the mistakes made, and the ways found that government must be reinvented if empowerment is to be a real public health tool.

Black or African American↗
PubMed1997

Reluctant rationers: public input to health care priorities.

Members of the public can adopt any one of at least three roles when providing input to public decision-making: taxpayer, collective community decision-maker, or patient. Each of these potential roles can be mapped onto three areas of public policy decision-making in health care: funding levels and organization for the system, the services we choose to offer under public funding, and the characteristics of those who should receive the offered services. The increasing desire to involve the public across the spectrum of health care decision-making has yet to result in a clear delineation of either which of the areas are most appropriate for public input or which of the roles we wish individual participants to adopt. The average citizen (as opposed to the self-interested patient, the provider or the manager) has so far shown little interest in contributing and rarely has the requisite skills for most of the tasks asked of him or her. The widespread motivation of governments and others for seeking public input appears to be to get the public to take or share ownership in the tough rationing choices consequent on fiscal retrenchment in health care. Evaluation of existing literature leads to the conclusion that there are only limited areas where we might wish to obtain significant public input if we adopt this widespread policy motivation. Specifically, the general public should be asked to give input to, but not determine, priorities across the broad service categories that could potentially be publicly funded. Members of the public have neither the interest nor the skills to do this at the level of specific services. The role expected of such members of the public should be made explicit and should focus on collective views of the community good rather than self-interested views of individual benefit. Groups of patients, however, should be the source of input when socio-demographic characteristics are being used to decide who should receive offered services. The role expected of these consumers is not, however, to take a self-interested perspective; rather, it is to adopt Rawls' 'veil of ignorance' to reflect compassionate views of priorities across socio-demographic characteristics. Finally, there appears to be no best method for obtaining public input that overcomes the common problems of poor information upon which to base priorities, difficulty in arriving at consensus, poor representativeness of participants, and lack of opportunity for informed discussion prior to declaring priorities. There is some suggestion, however, that panels of citizens or patients, convened on an ongoing basis and provided with the opportunity to acquire relevant information and discuss its implications prior to making consensus recommendations, offer the most promising way forward.

Canada↗
PubMed1998

Private provision of 'outreach' clinics to fundholding general practices in England.

OBJECTIVES: To establish the contribution of the private sector in providing outpatient 'outreach' clinics in general practitioner fundholding practices. METHOD: Postal survey of all 13 first-wave fundholders and four of the 13 second-wave fundholders in the former South East Thames Region of the National Health Service in 1995. RESULTS: Fourteen practices responded. Ten practices had set up at least one medical specialist 'outreach' clinic and 12 at least one paramedical clinic since becoming fundholders. Eight practices reported their arrangements for consultant 'outreach' clinics and ten practices their arrangements for paramedical clinics. Forty-nine per cent of the total medical specialist hours and 46% of total paramedical hours were provided by private practitioners. The largest number of hours provided privately was in gynaecology. CONCLUSION: This small study identified considerable private provision of fundholders' 'outreach' clinics. However, there is no system in the NHS to monitor the extent of this market, the types of activities undertaken or the relative quality and cost of the services provided.

Ambulatory Care Facilities↗
PubMed2006

Creative partnerships for community health improvement: a qualitative evaluation of the Healthy Carolinians community micro-grant project.

This qualitative study evaluated a recent innovative strategy used to involve community-based organizations (CBOs) in implementing health-related projects through locally administered microgrants. The purpose of this study was to identify key elements that enabled the success of the CBO projects, barriers and challenges to project success, and ways to effectively engage CBOs as partners in local health initiatives. In addition, this study sought to identify aspects of this approach that can be replicated. Study findings revealed that microfinancing CBOs aided in building partnerships, developing local leadership and expertise, and providing resources that enabled progress toward CBO missions and goals. These positive outcomes far out-weighed barriers and challenges faced by CBOs. Furthermore, the results of this study revealed ideas and information that provide useful guidelines for establishing and administering microgrant projects through local organizations that encourage community groups to design and implement community based health initiatives.

Advisory Committees↗
PubMed1997

Matter of choice.

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Community Participation↗